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Health literacy is a public health issue. Unpaid caregivers of older people with low health literacy may have difficulties providing care, exerting a negative impact on the care process. The aim of the present study was to perform a systematic review of the literature on factors associated with low health literacy in unpaid caregivers of older people. Searches for relevant articles were conducted in the Cochrane Library, Embase, LILACS, PubMed and Web of Science databases. A total of 1440 articles were identified, nine of which met the eligibility criteria and were included in the systematic review, which was registered in PROSPERO (CRD42024522986). A total of 2209 unpaid caregivers participated in the studies selected for this review. Most were women (67.2%). The average frequency of inadequate health literacy was 27.1%. Sociodemographic characteristics (i.e. advanced age, low educational level, the female sex), factors related to the care process (i.e. low acculturation, low empowerment, poor ability to read medication package inserts, lower care capacity, greater disease severity, hospitalization of care recipients), cognitive factors and factors related to quality of life/well-being (i.e. less social support, poorer quality of life, greater cognitive impairment, higher levels of burden) were associated with low health literacy. In conclusion, low health literacy in unpaid caregivers of older people is associated with sociodemographic, care-related and cognitive factors as well as factors related to quality of life/well-being. Low health literacy may exert a negative impact on the health of caregivers and, consequently, the quality of care provided to older people., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Objectives: To identify empathy training models and the effects on psychological concerns in paid and unpaid caregivers of older people., Methods: A systematic review was conducted. Searches for relevant articles were performed in the Embase, LILACS, PsycInfo, Pubmed, Scopus and Web of Science databases using the following search strategy: "Empathy AND (Education OR Training OR Intervention) AND Caregiver." No restrictions were imposed regarding language or year of publication., Results: Empathy training for caregivers of older people were performed in six studies, three of which identified a significant increase in empathy levels and consequent reduction in psychological concerns. Empathy training focused on aspects of empathy and/or the caregiver had significant effects on the outcome variables. Moreover, training conducted online, by telephone and/or in person can generate satisfactory results. The other three studies that conducted training with a focus on aspects of dementia and/or old age did not present any effect on the outcome variables., Conclusions: Empathy training for caregivers of older people can increase levels of this ability, especially in the cognitive domain, as well as diminish psychological concerns caused by the negative impact of providing care., Clinical Implications: Empathy training directed at empathic abilities and/or aspects of providing care can be effective at increasing levels of this ability. Moreover, training in different care contexts can minimize the negative impacts of providing care.

Objectives: Identify associations between psychological concerns and empathy (affective and cognitive domains) in paid and unpaid caregivers of older people., Methods: A systematic review of the literature was conducted. Searches were performed in the Pubmed, Web of Science, PsycINFO, Scopus and Embase databases using the search terms " Empathy," "Caregiver," "Depression," "Burnout," Anxiety", Caregiver Burden" and "Psychological Stresses" and the Boolean operators "AND" and "OR." No restrictions were imposed regarding language or year of publication. This review was registered in PROSPERO (CRD42021267276)., Results: Twelve articles met the inclusion criteria and were included in the present review. Most studies involved the participation of unpaid caregivers. Higher levels of empathy were associated with greater psychological concerns. Regarding affective empathy, direct associations were found with depressive symptoms, anxiety and stress. In contrast, high levels of cognitive empathy were associated with fewer depressive symptoms as well as less stress and burnout syndrome., Conclusions: An association was found between greater affective empathy and psychological impairment in caregivers of older people. Higher levels of cognitive empathy can help minimize psychological concerns., Clinical Implications: Working on empathic ability among caregivers of older people in different environments can contribute positively to the emotional impact of caregiving. Moreover, empathetic cognitive training among caregivers can serve as a strategy to minimize the negative consequences of the impact of caregiving.

Objectives: To investigate the effects of empathy training on psychological concerns and empathy in caregivers of older people., Methods: A randomized, double-blind, crossover, clinical trial with follow-up was conducted online. Thirty paid and unpaid caregivers of older people from different regions of Brazil participated in an empathy training program. The caregivers answered a sociodemographic questionnaire and measures for the evaluation of empathy (affective and cognitive domains), burden, the impact of providing care as well as depressive symptoms and psychiatric symptoms before and immediately after training. Empathy and its domains were also assessed at three post-intervention follow-ups., Results: Empathy training diminished levels of psychological concerns. Moreover, an increase was found in levels of cognitive empathy 15, 30 and 60 days after the intervention., Conclusions: Empathy training with a focus on cognitive empathy diminished psychological concerns in caregivers of older people and increased the levels of this ability over time. This intervention can be considered a coping strategy for negative impacts related to providing care., Clinica Ltrial Registration: RBR-8kjtfx3., Competing Interests: Declaration of competing interest No potential conflict of interest was reported by the author(s)., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Given the importance of dementia syndrome and its impacts on the population, interest in studying modifiable risk factors for dementia is growing., Objective: To compare the prevalence of risk factors for dementia in middle-aged and older adults over a two-year period and to identify what variables in baseline were predictive of cognitive decline in the follow-up., Methods: Longitudinal and quantitative study, with follow-up evaluation after two years, conducted with 200 participants aged 45 years or more, registered in Primary Care Units. In the baseline (2018/2019) and follow-up (2021) assessments, sociodemographic data were collected, and cognitive performance and risk factors for dementia were evaluated (education, hearing loss, head trauma, high blood pressure, alcohol use, obesity, smoking, depressive symptoms, social isolation, physical inactivity, and diabetes mellitus). Data were compared using the McNemar's test. Individual multinomial logistic regression models were performed to identify the factors associated with cognitive decline after two years., Results: The percentages of low education, traumatic brain injury, and smoking remained the same in both assessments. There was a significant increase in the prevalence of high blood pressure (from 55.0 to 62.0%) and physical inactivity (from 58.5 to 74.5%) and a significant reduction in social isolation (from 25.0 to 18.0%). Participants with depressive symptoms in baseline had a higher risk of cognitive decline in follow-up., Conclusion: There was an increase in the prevalence of high blood pressure and physical inactivity and a reduction in social isolation after two years. Depressive symptoms predict cognitive decline., Competing Interests: Disclosure: The authors report no conflicts of interest.

Objectives: To identify factors associated with self-reported happiness among community-dwelling older adults., Methods: A systematic review of the literature was conducted. Searches were conducted in the PsycInfo, Web of Science, Scopus and Pubmed databases for relevant articles published in English, Spanish or Portuguese using the following search strategy and Boolean operators: (happiness*) AND (elder* OR (old adult*)). No restriction was imposed with regards to year of publication. This review was registered in PROSPERO (CRD42018107302)., Results: Forty-six articles met the eligibility criteria and were included in the review. Economic, social and health-related factors were associated with happiness among community-dwelling older adults. The sociodemographic characteristics of older adults, such as the female sex, being married, an older age, a higher level of schooling and having a religion, were also associated with happiness., Conclusions: The articles included in the present systematic review demonstrate that social, economic and health-related aspects have an association with happiness in community-dwelling older adults., Competing Interests: Declaration of competing interest All authors declare that they have no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives: To identify factors associated with poor health literacy in older adults., Methods: A systematic literature review was conducted, employing the descriptors "Aged" and "Health Literacy"., Prospero - Crd: 42022350140., Results: Out of 23,500 articles screened, 176 were selected. Several factors associated with poor health literacy in older adults were identified, such as sociodemographic (e.g., advanced age, low educational level, non-white population, and others), social (e.g., poor family/social support, loneliness, social isolation, few social activities, and others), economic (e.g., lower income and/or lower socioeconomic status) and health aspects (e.g., poor health, chronic conditions, mental health challenges, hospitalizations, frailty, physical inactivity, cognitive impairment, and others)., Conclusions: The factors associated with poor health literacy in older adults identified in this review could contribute to future research, support interventions to improve health literacy, and assist professionals in planning educational activities and public policies., Competing Interests: Declaration of Competing Interest All authors declare that they have no conflicts of interest., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Due to the rapid advance of the pandemic caused by COVID-19, several countries perceived that human and material resources would be insufficient to meet the demand of infected patients. The aim of this study is to analyze the knowledge of health professionals working in the pandemic about the application of ethical criteria in decision-making in situations of resource scarcity. This is a cross-sectional, descriptive, and quantitative survey study, conducted from June to December 2020, with health professionals working in the COVID-19 pandemic in Brazil. We applied a questionnaire to assess the professionals' knowledge about ethical criteria in decision-making in the allocation of scarce resources during the pandemic, containing 14 questions and possible score from 0 to 70, which was developed by researchers from documents and protocols validated by organizations from various countries, available in the first months of the pandemic, a sociodemographic characterization questionnaire and a self-assessment questionnaire regarding knowledge about bioethics. A total of 197 health professionals participated in the study, 37.6% of whom were nurses and 22.8% of whom were physicians, working in the Family Health Unit (28.4%) with a degree at the level of specialization (46.2%). Moreover, (9.5%) of nurses, (18.2%) of dental surgeons and (24.4%) of physicians reported that they have no prior knowledge about bioethics. Physicians and hospital workers scored higher on the knowledge assessment questionnaire. The mean score of the participants was 45.4 (SD = 7.2). Investments in training and professional education in the field of health focused on Bioethics are necessary, considering models and ethical theories that help professionals, managers and society to better position themselves in the face of pandemic contexts., (© 2023. The Author(s) under exclusive licence to Monash University.)

Objectives: The objective of the study was to evaluate the factors associated with symptoms of posttraumatic stress in mothers during the COVID-19 pandemic., Methods: Cross-sectional study conducted with mothers of children and adolescents living in Brazil, who answered an online questionnaire containing sociodemographic variables and the Impact of Events Scale-Revised. The Poisson regression model with robust variance was used to identify the factors associated with posttraumatic stress., Results: A percentage of 83.82% of mothers reported an overload in caring for their children during the pandemic. The prevalence of posttraumatic stress symptoms was 39.05%, and this condition was associated with younger age, living in the northern region of the country, using medications, presenting neuropsychiatric comorbidities and being little/more or less satisfied with life., Conclusions for Practice: The mental health situation of mothers during and after the pandemic must be monitored, in order to guarantee public policies capable of optimizing the coping with the situation., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: To evaluate the relationship between depressive symptoms and sleep quality in aged caregivers of elderly people, in a context of high social vulnerability., Methods: A Cross-sectional study conducted between July 2019 and March 2020 with 65 aged caregivers of elderly people that were treated in five Family Heath Units from São Carlos, São Paulo. Instruments to characterize the caregivers and to evaluate the depressive symptoms and sleep quality were used in data collection. The Kruskal Wallis and Spearman Correlation tests were adopted., Results: 73.9% of the caregivers presented poor sleep quality and 69.2% did not have depressive symptoms. In the caregivers with severe depressive symptoms, the mean sleep quality score was 11.4; in those with mild depressive symptoms, it was 9.0; and in those without depressive symptoms, it was 6.4. There was a direct and moderate correlation between sleep quality and depressive symptoms., Conclusion: There is a relationship between depressive symptoms and sleep quality in aged caregivers.

The current study aimed to assess influenza vaccination coverage and explore factors related to vaccine uptake in older adults in 2020 amid the coronavirus disease 2019 pandemic. A cross-sectional study using an online questionnaire was performed with 380 older adults (aged ≥60 years), living in Brazil, from May 26 to June 29, 2020. Data regarding sociodemographic, health, and social support variables were collected. Data were analyzed using Poisson regression with robust variance. Influenza vaccination coverage in the sample was 85.5% (95% confidence interval [81.6, 88.7]). Older adults with increased age had higher vaccination coverage, whereas those who were smokers, not wearing masks, and sometimes and never/almost never received professional support had lower vaccination rates. Data show that vaccine coverage for influenza in 2020 was below that recommended by Brazilian authorities. We reinforce the importance of information about the influenza vaccine, especially for younger older adults, smokers, and those who do not wear masks. Reliable information from health care professionals and the media is essential for vaccination during a pandemic. [ Journal of Gerontological Nursing, 49 (5), 31-38.].

The task of caring can negatively affect the physical and mental health; therefore, it is important to understand which factors are associated with burden in older caregivers of older adults., Objective: This study aimed to explore sociodemographic, clinical, and psychosocial factors associated with burden in older caregivers of older adults., Methods: This is a cross-sectional study developed with 349 older caregivers who were registered at a Family Health Unit of a city in the state of São Paulo, Brazil. Household interviews were conducted and data were collected on the sociodemographic (profile, family income), clinical (self-reported pain, sleep, frailty), and psychosocial (burden, family functioning, depressive symptoms, stress) characteristics of the caregivers as well as dependence on activities of daily living and cognition in the care recipients., Results: Women predominated in the sample (76.5%) and mean age was 69.5 years. The mean burden score was 18.06 points, with 47.9% above the cutoff of 16 points, denoting excessive burden. The bivariate model revealed associations between burden and financial insufficiency, family dysfunction, difficulty sleeping, pain, perceived stress, depressive symptoms, frailty, and multimorbidity among the caregivers as well as worse functional and cognitive performance in the care recipients. The controlled model revealed an association between burden and depressive symptoms (β=16.75; 95%CI 1.80-31.68)., Conclusions: We identified an association between burden and depressive symptoms, underscoring the need for the planning and implementation of specific actions directed at caregivers in order to minimize the impact on health and to improve the quality of life., Competing Interests: Disclosure: There authors report no conflicts of interest.

The prevalence of chronic diseases, especially depression, has been increasing worldwide. Health professionals have an important role in screening and early detection of the disorder, to prevent possible damage such as disability and dependence. With aging, sensory impairments can occur, such as visual and hearing losses, which can lead to isolation contributing to the development of depressive symptoms. The objective of this study was to analyze the relationship between depressive symptoms, social isolation, and self-perception of visual complaints and hearing loss in middle-aged and older adults. It was a cross-sectional quantitative study, in Três Lagoas, state of Mato Grosso do Sul, Brazil, with 300 participants of both sexes, aged 45 years and over, registered in the Primary Health Care network. Data were collected using a structured questionnaire with sociodemographic data and the questions "Do you consider yourself socially isolated?", "Do you have a vision and/or a hearing problem capable of stopping you from performing a daily life activity?" and "If yes, do you use a hearing aid and/or glasses or contact lenses?". Depressive symptoms were assessed using the Center for Epidemiological Studies - Depression (CES-D) scale with a cut-off score adapted for age. Data were analyzed with binary logistic regression, with the presence of depressive symptoms being the dependent variable. Values of p≤0.05 were considered significant. The majority of the sample were women (65.7%), with an average age of 60.9 years, 56.7% were classified with depressive symptoms, 27.0% considered themselves socially isolated, 84.7% reported visual acuity loss (70.7% used glasses) and 17.3% reported hearing loss (2.3% used hearing aids). Social isolation (OR = 6.0), visual complaints (OR = 3.85), and hearing loss (OR = 4.67) were related to the presence of depressive symptoms. Moreover, being married (OR = 0.51) was a protective factor in these participants. The results showed the importance of early diagnosis of depressive symptoms. The correction of visual and hearing deficits is highlighted, as these may be related to symptoms of depression. Health professionals in Primary Health Care should be able to monitor depressive symptoms, visual and hearing complaints, and to promote social interaction.

The aim of the present systematic review was to investigate cultural factors associated with burden in unpaid caregivers of older adults. Searches were conducted in the Pubmed, Web of Science, PsycInfo, Scopus, Embase, LILACs and SciELO databases for relevant articles published in English, Portuguese and Spanish using the search terms 'Caregiver AND Culture AND (Burnout OR Caregiver Burden) AND Aged'. No restriction was imposed regarding year of publication. A total of 1234 articles were identified, 34 of which were selected for the present review. The following sociodemographic characteristics were associated with burden: being female, married, White caregivers, young and the spouse of the care recipient; having no siblings; having low schooling and low economic status. Cultural factors associated with burden were living with the care recipient, not professing a religion or having little spirituality, familism (i.e. less reciprocity) and an absence of social support. The present findings underscore the importance of developing intervention strategies that consider cultural factors to minimise the negative impacts of care on unpaid caregivers of older adults., (© 2022 John Wiley & Sons Ltd.)

Objectives: To assess differences in the recognition of facial expressions of emotion among caregivers of older people with different levels of empathy., Methods: A cross-sectional study was conducted with 158 caregivers of older adults who provided care in family residences or nursing homes. The caregivers were divided into three groups based on the score of the multidimensional Interpersonal Reactivity Index: "lower empathy", "intermediate empathy", and "higher empathy". Data collection involved the administration of a sociodemographic questionnaire, the Emotion Recognition Test, and the Patient Health Questionnaire., Results: No significant differences were found among the groups in terms of sociodemographic variables. Regarding clinical characteristics, the "higher empathy" group had more depressive symptoms than the other groups ( p = .001). Moreover, the "higher empathy" group exhibited greater accuracy at recognizing the expression of sadness than the "lower empathy" group ( p = .033). The recognition of sadness remained significant in the analysis of variance adjusted for depressive symptoms ( p < .05)., Conclusions: Caregivers with higher levels of empathy showed greater accuracy at recognizing sadness emotion compared to caregivers with lower levels of empathy. Additionally, caregivers with greater empathy have more depressive symptoms., Clinical Implications: The recognition of facial expressions of sadness may give caregivers a skill to infer possible needs in older care recipients. However, a higher level of empathy may exert a negative psychological impact on caregivers of older people, which could have repercussions regarding the quality of care provided.

The objective of this study was to identify the relationship of burden with depressive symptoms, mental disorders and older adults' functional dependence in paid and unpaid caregivers. This is a quantitative and cross-sectional study, carried out in the inland of the state of São Paulo with 111 caregivers, 60 of whom were unpaid and 51 were paid. The caregivers answered a questionnaire for the assessment of sociodemographic and care characteristics, the Zarit Burden Inventory (ZBI), the Patient Health Questionnaire (PHQ-9), the Self-Report Questionnaire (SRQ-20), and the Functional Assessment Questionnaire (FAQ). Unpaid caregivers were older, married, have been providing care for a longer period of time, and devoted more days and hours per week to care when compared to paid caregivers. Depressive symptoms and mental disorders (non-psychotic) are related to the levels of burden in both paid and unpaid caregivers (p < 0.001). The care process causes harm such as burden, depressive symptoms, and mental disorders in paid and unpaid caregivers. Thus, it is important to think about coping strategies to minimize the psychological consequences of the care process., (© 2021 John Wiley & Sons Ltd.)

Objective: To assess the level of agreement between the Subjective Frailty Assessment (SFA) and Clinical Functional Vulnerability Index (CFVI-20) for the diagnosis of frailty in older adults., Methods: A descriptive, comparative, cross-sectional study was conducted in 2018/2019 with 492 older adults at nine Family Health Strategy units in the city of Três Lagoas, state of Mato Grosso do Sul, Brazil. Frailty was assessed using the SFA and CFVI-20 in addition to a structured interview. The Wilcoxon test and Pearson's chi-squared test were used for the comparisons., Results: Agreement was 35.4%, with a Kappa coefficient of 0.11. After dichotomizing the sample into frail and non-frail individuals, agreement was 70.1%, with a Kappa coefficient of 0.41 and Cronbach's alpha coefficients of 0.61 and 0.74 for IVCF-20 and SFA, respectively. The prevalence of frailty was lower using the IVCF-20 (17.1%) compared to 59.8% using the SFA., Conclusion: Agreement regarding the classification of frailty between the two instruments ranged from low to moderate. This finding underscores the need for a standardized instrument for measuring frailty in community-dwelling older adults.

Purpose: To check the association between a good performance of language and the recognition of facial emotional expressions in elderly individuals., Methods: Transversal study performed with 118 elderly individuals from the primary care services of health of a city in the state of São Paulo. Sociodemographic data were collected, regarding the performance of language through the domain of Addenbrooke Cognitive Examination - Revised and Recognition of Facial Emotional Expressions. The sample was divided in thirds according to the performance of language: T1 = the best, T2 = average, and T3 = the worst. The groups T1xT3 were compared regarding the performance of recognition of facial expressions of anger, disgust, fear, happiness, sadness, and surprise, and for the intensities of 40%, 60%, 80%, and 100%. The association of independent variables over the performance of language was analyzed through logistic regression. The multivariate model was built from the results of the univariate analyses and has included the continuous variables by emotion and by intensity. Age and schooling associated to the performance of language in the univariate model were included in the multivariate model in order to adjust association analyses., Results: The sample was mainly female (84.7%), with an average age of 70.5 years old, and 3.5 schooling years. The variables associated to the best performance of language in comparative analysis of T1 and T3 were: surprise (OR = 1.485, IC 95% 1.194 - 1.846), and disgust (OR = 1.143, IC 95% 1.005 - 1.300)., Conclusion: The recognition of facial emotional expressions of surprise and disgust were shown as important factors associated to the good performance of language.

Combination of cognitive impairment, frailty, perceived stress, and excessive burden poses a risk to the health of caregivers., Objectives: This study aimed to investigate the influence of the combination of these conditions on the occurrence of hospitalizations and deaths among older caregivers in a 4-year follow-up period., Methods: This is a longitudinal study in the communities with 351 older caregivers who underwent gerontological and geriatric evaluations in 2014 and completed cognitive (Mini-Mental State Examination), physical frailty (Cardiovascular Health Study criteria), perceived stress (Perceived Stress Scale), and care burden (Zarit Burden Interview) assessments. In 2018, data on hospitalization and mortality were collected., Results: As a result, 32 (12.6%) caregivers had deceased. Among the 228 survived caregivers who were reevaluated, 24% reported using hospital services in the previous year. Mean length of hospital stay was 3 days (range: 1-22 days). Hospitalization was associated with cognitive impairment co-occurring with frailty (p=0.05), stress (p=0.03), burden (p=0.01), and frailty co-occurring with stress (p=0.04). Considering singular effects, the mortality rate (33.3%) was higher among frail caregivers, followed by those with cognitive impairment (23.1%) and a high level of perceived stress (20.4%). Considering accumulative conditions, mortality rate (43.8%) was higher among frail older caregivers with cognitive impairment, followed by those with a high level of perceived stress and cognitive impairment (32.4%)., Conclusions: The investigation of accumulated effects is important to the identification of potentially vulnerable older caregivers as well as the management and monitoring of the care, health, and independence of those who provide care for other older adults., Competing Interests: Disclosure: The authors report no conflict of interest.

Objective: Evaluate the effects of clown activities on quality of life, depression, stress, anxiety, aid, and social support in patients eligible for palliative care (PC) attended in Primary Health Care (PHC)., Method: A quasi-experimental study, with pre-intervention and post-intervention evaluation, carried out with 16 patients eligible for early PC in PHC in a Midwestern city. Patients received 24 visits with home-based clown activities., Results: The interventions evidenced improved quality of life and social support, with significant results for the Social Activities dimension (p = 0.023). Increased scores for Anxiety (p = 0.007) and Depression (p = 0.023) were also observed., Conclusion: Clown activities can bring positive results for the quality of life and social support of patients eligible for PC at home. They should be encouraged to interact with family knowledge and enhance humanized care, integral and centered on human relationships in PHC.

Objective: to analyze the relationship between the duration of self-reported night sleep and the cognitive performance of older adults., Method: the sample consisted of 156 older adults registered in Family Health Units (FHUs) in a city of São Paulo, divided into quartiles according to the duration of night sleep. Data collection was performed using a characterization questionnaire, Addenbrooke's Cognitive Exam - Revised (ACE-R) and Pittsburgh Sleep Quality Index (PSQI). Descriptive, comparative and correlational statistical analyses were performed., Results: the older adults obtained a mean of 61.94 points in ACE-R and 55.1% presented good sleep quality. Comparative analyses showed differences between the groups only in the cognitive domain of verbal fluency (p=0.018). The post-hoc analyses showed that older adults who slept more hours, a mean of 8.85 hours (Q1), had lower scores when compared to those who slept a mean of 6.11 hours (Q3) (p=0.004) and of 4.52 hours (Q4) (p=0.045). The adjusted model with application of the stepwise method showed a relationship between the independent variables of schooling and sleep duration and the domain verbal fluency., Conclusion: it is concluded that sleep duration is related to the verbal fluency cognitive domain.

It is important to assess the prevalence of risk factors for dementia to slow down the progression and evolution of the disease, and to support interventions and prevention programs., Objective: We aimed to evaluate the prevalence of these factors in individuals registered in Primary Health Care in Brazil and their relationship with sex and age group., Methods: This was a cross-sectional and quantitative study with n=300 individuals. We evaluated the prevalence of main risk factors (low education, hearing loss, high blood pressure, obesity, smoking, depression, physical inactivity, social isolation, and diabetes mellitus) and others (poor diet, alcohol use, head trauma, monolingualism, visual impairment, and sleep disorders) identified in the literature. Poisson regression was used, according to sex and age group (45-59 years/60+ years)., Results: The main risk factors with the highest prevalence were physical inactivity (60.3%) and depressive symptoms and hypertension (56.7% each). Among the other factors, monolingualism (98.0%), visual impairment (84.7%), and irregular consumption of fruits (60.4%), and vegetables (53.5%) prevailed. No differences were identified between sexes. The regression analysis confirmed a significant difference for education and age group, with older individuals having a higher prevalence of low schooling., Conclusion: The results can guide interventions, especially in developing countries. Practice of physical activity and healthy eating should be the focus of these interventions as they can indirectly help in reducing the prevalence of other factors. Early identification, screening and adequate treatment of depressive symptoms, high blood pressure and visual impairment can also contribute to reducing the prevalence of dementia., Competing Interests: Disclosure: The authors report no conflict interests.

Given the benefits of adequate family function for the health and well-being of older adults, it is important to understand what factors predict adequate family function in older people who care for their spouses., Objective: Analyse predictors of family function in older spousal caregivers., Methods: A cross-sectional study design was used to investigate a non-probabilistic sample of 298 older spousal caregivers. Home-based face-to-face interviews were used to evaluate sociodemographic variables and care context, family function (Family APGAR), cognitive function, perceived stress, and depressive symptoms. Data were analysed using multiple logistic regression with stepwise forward method for variable section., Results: Older caregivers having some degree of cognitive impairment (OR=-0.160, 95%CI 0.444-0.579), depressive symptoms (OR=-0.848, 95%CI 0.726-0.992) or high levels of stress (OR=-0.955, 95%CI 0.914-0.999) had overall lower levels of family function. Having more children was linked to approximately 1.3 times higher family function (95%CI 1.080-1.057)., Conclusion: Stress, depression, cognitive decline, and number of children are predictors of family function and should be considered in social and health care strategies within the family caregiving context., Competing Interests: Disclosure: The authors report no conflicts of interest.

Due to the importance of annual flu vaccination in the elderly, the study aimed to analyze the impact of influenza vaccination on morbidity and mortality from influenza in the elderly from 2010 to 2019 in the major geographic regions of Brazil. This is an ecological epidemiological study with data from the Information System of the National Immunization Program, Hospital Information System, and Mortality Information System, available from the Brazilian Ministry of Health. Data referred to Brazil and its five major regions and included influenza vaccination coverage rates in the elderly and morbidity and mortality from causes related to influenza and pneumonia in the elderly. Simple linear regression models were used to study the relationship between morbidity and mortality and vaccination coverage rates. There was an increase in vaccination coverage during the period, and the target of 80% coverage was reached in all the regions since 2011. A directly proportional statistical association was identified between the study variables, and the increase in vaccination coverage was associated with an increase in morbidity and mortality from the target causes. These data may be related to reports in the literature showing that the vaccine's effect is modest in the elderly. However, the rates' calculation does not take the population's aging into account, using data from outdated census estimates. Besides, the hospitalization and mortality data may include other circulating viruses and bacteria besides influenza. The maintenance of high vaccination coverage may prevent the impact of influenza from being even higher on morbidity and mortality in the elderly.

Objective This study aimed to investigate factors associated with empathy and identify instruments used to measure this ability in professionals and students in the health field. Method A systematic review was performed. Searches were conducted on the PsycINFO, PubMed, Web of Science, and Scopus databases using the keywords "empathy" and "health professional". We selected 29 articles published in English, with no restriction imposed regarding the year of publication. Results Based on the findings of the articles selected, sociodemographic factors (female gender, being married, being older, having siblings, and having children) are associated with higher levels of empathy. Professional experience (years of practice) and being on the final years of the course also contributed to higher levels of empathy. Different versions of the Jefferson Scale of Empathy were the most prevalent assessment tools employed in the different studies. Conclusion The articles analyzed describe several factors that influence the level of empathy among health professionals and students. Thus, future studies should take sociodemographic factors into account when evaluating levels of empathy in this population.

Cognitive health is important for the quality of life and well-being of elderly caregivers. Cognitive impairments can negatively affect the ability to care for oneself and others., Objective: To compare cognitive performance and aspects of the care context in elderly caregivers of older adults in a three-year follow-up investigation., Methods: A longitudinal study was conducted of 61 elderly caregivers treated in primary care in a city in the interior of the state of São Paulo with data collected in 2014 and 2017. Sociodemographic characteristics, the care context, cognition, performance for activities of daily living, burden and depressive symptoms were collected in individual interviews. Data analysis was performed to compare categorical and continuous variables., Results: Significant increases were found between baseline and follow-up for the language domain score of the cognitive evaluation (p=0.024), receipt of material support (p=0.020), time providing care (p=0.045) and dependence of elderly care recipient for basic activities of daily living (p=0.042)., Conclusion: Elderly caregivers performed better on the domain of language, received more material/financial support, spent more time on care and reported greater dependence of the elderly care recipient., Competing Interests: Disclosure: The authors report no conflicts of interest.

Objective: Evaluate the cumulative effects of cognitive impairment and frailty on functional decline, falls and hospitalization in older adults over a four-year period., Method: Four hundred five older adults (60-95 years; mean age: 70.62 ± 7.12 years), 57 % female. The frailty evaluation was performed using the clinical criteria of the Cardiovascular Health Study (CHS): weight loss, fatigue, weakness, slowness and low physical activity. Cognitive impairment was defined by cutoff scores of the Mini Mental State Examination (MMSE) based on schooling. Follow-up - functional decline was assessed using the Lawton&Brody scale of instrumental activities of daily living (IADL). An investigation was also performed of the occurrence of falls and admissions to the hospital in the previous twelve months., Results: Cognitive impairment was associated with admissions to the hospital and declines in the IADL category of using a telephone. Frailty was associated with admissions to hospital. Cumulative effects were observed for hospitalization and the decline in using the telephone and shopping. Frailty and cognitive impairment increased the risk of being admitted to hospital by 557 % and increased the risk of a decline in using the phone by 262% and shopping by 208%. No conditions were associated with the risk of falls., Conclusion: The combination of the MMSE and the CHS criteria was adequate for measuring the cumulative effects of cognitive impairment and frailty. Shared physiological mechanisms may explain the relation between cognitive impairment and frailty, but further investigations are needed in Brazil and other low/middle-income countries., Competing Interests: Declaration of Competing Interest The authors whose names are listed immediately below certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript., (Copyright © 2019 Elsevier B.V. All rights reserved.)

This article aims to compare level of burden, optimism and coping strategies among elderly caregivers of other elderly individuals who reside with and without children. A cross-sectional study was with a sample of 301 elderly caregivers of elderly Brazilians seen in primary health care. Among the 301 caregivers interviewed, 44 resided with children and 257 did not. Evaluations involved the administration of the Zarit Burden Inventory, Spirituality Scale (optimism) and Coping Strategies Inventory. Either the Student's t-test or the Mann-Whitney U-test was used for the comparisons between the two groups. Burden level was significantly higher among elderly caregivers who resided with children (p = 0.01). No significant differences were found with regard to optimism. Elderly caregivers who did not reside with children reported significantly greater use of coping strategies focused on the expression of negative emotions (p < 0.01), religiosity (p < 0.01) and the inhibition of negative emotions (p = 0.01). The elderly caregivers of other elderly individuals who resided with children had a higher level of burden and used coping strategies less than those who did not reside with children.

Introduction: Providing care to an older adult is an activity that requires considerable physical effort and can cause stress and psychological strain, which accentuate factors that trigger the cycle of frailty, especially when the caregiver is also an older adult. However, few studies have analyzed the frailty process in older caregivers., Objectives: To investigate the prevalence of pre-frailty, frailty and associated factors in older caregivers of older adults., Methods: A cross-sectional study was conducted including 328 community-dwelling older caregivers. Frailty was identified using frailty phenotype. Socio-demographic, behavioral and clinical aspects, characteristics related to care and functioning were covariables in the multinomial logistic regression., Results: The prevalence of pre-frailty and frailty were 58.8% and 21.1%, respectively. An increased age, female sex, not having a conjugal life, depressive symptoms and pain were commonly associated with pre-frailty and frailty. Sedentary lifestyle was exclusively associated with pre-frailty, whereas living in an urban area, low income and the cognitive decline were associated with frailty. A better performance on instrumental activities of daily living reduced the chance of frailty., Conclusion: Many factors associated with the frailty syndrome may be related to the act of providing care, which emphasizes the importance of the development of coping strategies for this population.

Objective: to identify factors associated with depressive symptoms in elderly caregivers with chronic pain., Method: the study included people 60 years of age or older who reported chronic pain and cared for another elderly person living in the same household (n=186). Statistical analyzes were performed using the Mann-Whitney test, univariate and multiple logistic regression., Results: most participants had no depressive symptoms (70.4%), 24.2% had mild depressive symptoms and 5.4% had severe symptoms. Univariate analysis showed that the variables family income, number of diseases, number of medications in use, pain intensity, overload and perceived stress were associated with depressive symptoms. Multivariate analysis found an association with perceived stress (95% CI 1.101-1207) and number of medications (95% CI 1.139-1.540) in use., Conclusion: factors associated with depressive symptoms in elderly caregivers with chronic pain were stress and the number of medications in use.

Objective: evaluate the factors associated with the risk of diabetes mellitus in older caregivers., Method: this is a cross-sectional study conducted with 326 older caregivers enrolled in Family Health Units. Data were collected using a sociodemographic characterization questionnaire, clinical and care information, and the Finnish Diabetes Risk Score to assess the risk of developing diabetes., Results: 35.5% of the caregivers presented a high risk of developing diabetes. The factors associated with the risk of developing diabetes were: use of medication (OR = 3.88), satisfactory or poor health assessment (OR = 1.72), and the fact of being female (OR = 0.48)., Conclusion: more than one third of older caregivers present high risk of developing diabetes. Therefore, being female, living with other people, using medication, and having a poor health assessment are factors associated with increased risk of developing diabetes.

Objective: to investigate the association between frailty, loneliness and depressive symptoms of elderly caregivers., Method: a cross - sectional study carried out with 341 elderly caregivers enrolled in Family Health Units of a city in the countryside of São Paulo State. The interviews were domiciliary and included questionnaire for characterization of the caregiver, Fried's frailty phenotype, family APGAR (family functionality), Geriatric Depression Scale (depressive symptoms) and item 3 of the Herth Hope Scale (loneliness). Logistic regression was used to analyze the association between depressive symptoms and solitude (independent variables), and frailty and pre-frailty (dependent variables)., Results: there was an association between frailty, loneliness and depressive symptoms. Elderly caregivers had increased odds of 158% presenting pre-frailty, and 360% of frailty. Elderly caregivers with depressive symptoms had an increased chance of 242% of presenting fragility., Conclusion: elderly and lonely caregivers with depressive symptoms are more likely to be frail and pre-frail.

Objective: To perform a systematic review of articles evaluating implicit attitudes of health professionals and undergraduate students in the health field toward the elderly., Methods: The PsycINFO, PubMed, Web of Science, Scopus and LILACS databases were searched for relevant articles published in English, Portuguese and Spanish using the following search terms: implicit attitude AND (elderly OR aged OR older people). Seven articles were selected., Results: The majority of studies were conducted in developed countries and found negative attitudes toward the elderly, with males exhibiting more negative attitudes than females., Conclusion: The articles analyzed in this review demonstrate an implicitly negative attitude among professionals and students in the field of health toward the elderly.

Objective: To compare the physical, cognitive and psychological health profile and care context of elder caregivers of the elderly in different home arrangements., Method: Quantitative and transversal study with elderly caregivers. The sample consisted of 349 caregivers divided into mono-gerational, bi-gerational and multi-generational housing arrangements. Sociodemographic and care questionnaires and physical, cognitive and psychological health assessment instruments were used for evaluation. The Chi-square distribution and Mann Whitney's U were used for data analysis., Results: Elderly caregivers in mono-generational homes were significantly older and independent for instrumental activities of daily living. In multigenerational households there was a significantly greater proportion of caregivers who considered family income insufficient, received emotional help, and felt overwhelmed and stressed., Conclusion: The differences identified between the groups can contribute to the elaboration of care policies and for the health promotion of elderly caregivers.

Objective: The aim of this study is to analyze the prevalence of physical inactivity (PI) and associated factors in older caregivers of older adults., Method: A cross-sectional study was conducted including 312 older caregivers. Sociodemographic, clinical, and care-related characteristics were considered the independent variables for the determination of associated factors with PI in the logistic regression model., Results: The prevalence of PI was 75.3% (95% confidence interval [CI] = [70.1%, 80.0%]). The following factors were associated with PI: being female (odds ratio [OR] = 2.8, 95% CI = [1.3, 5.9]), being older than 75 years of age (OR = 7.1, 95% CI = [2.2, 22.9]), not having a marital life (OR = 4.2, 95% CI = [1.1, 15.8]), being prefrail (OR = 6.2, 95% CI = [1.7, 21.9]), and being frail (OR = 14.8, 95% CI = [3.8, 57.7])., Discussion: The prevalence of PI was high and associated with the female sex, an advanced age, and not being married. Specific public policies considering these results should be created for older caregivers.

The degree of burden related to the demands of daily care provided to a dependent older adult is important to evaluate due to the negative influence exerted on caregivers' physical and psychological health., Objective: To analyze the validity of the 12-item version of the Zarit Burden Interview administered to older caregivers of community-dwelling older dependent individuals and suggest a cut-off score based on quartiles., Methods: Three hundred and forty-one older caregivers (mean age: 69.6±7.1 years; 76.8% women) registered with primary healthcare centers were evaluated using the ZBI-12. Additional evaluations addressed stress (Perceived Stress Scale [PSS]), depressive symptoms (Geriatric Depression Scale [GDS]) in the older caregivers and the degree of dependence of the older care recipients (Lawton and Brody [L&B])., Results: Cronbach's alpha demonstrated very good internal consistency (α=0.81). Correlations were found between all ZBI-12 items and overall score on the PSS (r=0.53; p<0.01). GDS (r=0.43; p<0.01) and L&B (r= -0.23; p<0.01) scale scores. The PSS demonstrated the strongest correlation with ZBI-12 score and proved to be the standard reference. Based on caregivers with a higher degree of stress considering the PSS score quartiles, a cut-off score of 13 points on the ZBI-12 is suggested for screening burden in community-dwelling older caregivers, but should not be assumed as normative data., Conclusion: The ZBI-12 can be considered valid for evaluation of burden in clinical practice and research as a fast, efficient option for screening burden among older caregivers of community-dwelling older adults., Competing Interests: Disclosure: The authors report no conflicts of interest.

Objective: To explore the socioeconomic, demographic and psychosocial factors associated with cognitive performance in elderly caregivers from Brazil., Methods: We evaluated 351 Brazilian elderly caregivers attending primary healthcare services regarding sociodemographic and care variables. Addenbrooke's Cognitive Examination-Revised (ACE-R) domains of orientation/attention, memory, verbal fluency, language and visuospatial were used as dependent variables in the Tobit model., Results: Literacy and family income were positively associated with all ACE-R domains. Age, gender, time of care (days/week) were negatively associated with some cognitive domains. Moreover, receiving emotional help and the level of hope were positively associated with specific domains., Discussion: The results may be useful for planning interventions aimed at elderly caregivers in order to prevent deficits in the different cognitive domains.

Cognitive aging is dynamic and heterogeneous in elderly, thus adequate tools such as paper-based tests are relevant to describe the cognitive profile of this population., Objective: To describe different paper-based cognitive assessments tests in elderly people stratified by age and education., Methods: A cross-sectional study of 667 elderly (≥60 years) living in the community was conducted. Sociodemographic information was collected. Global cognition was assessed by the Addenbrooke's Cognitive Examination-Revised (ACE-R), Mini Addenbrooke's Cognitive Examination (M-ACE) and Mini-Mental State Examination (MMSE). The data were analyzed using descriptive statistics, the t-test and Pearson's Correlation Coefficient., Results: The findings showed a predominance of women (53.8%), mean age of 71.3 (±7.7) years and 3.6 (±3.5) years of education. The best global cognitive performance and cognitive domain assessment scores were found in the group with higher formal educational level. Each year of education was associated with an increase of up to 10% in scores on the M-ACE and MMSE and up to 11% in ACE-R scores. The mean values of the scores varied according to age, where the 60-69 years group had better scores than other age groups. The correlation matrix between the cognitive tests showed that near perfect correlations (r=1) were frequent in the subgroup with higher education., Conclusion: Younger elderly and those with higher educational level had greater global and domain scores. This study describes the scores of elderly for different strata of education and age. In practice, it is important to choose the most suitable screening instrument, considering the characteristics of the elderly., Competing Interests: Disclosure: The authors report no conflicts of interest.

Changes in patterns of performance for the cognitive functions of memory, processing speed, and focused attention are expected in old age., Objective: The main goal of this systematic review was to analyze the use of ERP in healthy elderly in studies evaluating the P300 components., Methods: A systematic review was carried out based on recommendations for nursing research on the databases LILACS, PsycINFO, PubMed, SCOPUS and Web of Science ., Results: 26 studies involving 940 healthy elderly were identified, most of which sought to identify and determine the influence of age on the P300., Conclusion: Although there is consensus in the literature that P300 latency is significantly longer in elderly with psychiatric disorders compared to healthy elderly, it was not possible to conclude P300 associations with gender, education and other cognitive tests., Competing Interests: Disclosure: The authors report no conflicts of interest.

Objective: The aim of the present study was to evaluate factors associated with happiness in a sample of Brazilian older adults., Methods: A study was conducted with 263 elderly people in the area of coverage of a family health unit located in the state of São Paulo, Brazil. The Subjective Happiness Scale was used to measure happiness, the final score of which determined one of three outcomes: not happy, intermediate, and happy. Disability, sociodemographic characteristics, and psychological, cognitive, and physical factors were considered for the multinomial logistic regression analysis., Results: Statistically significant differences were found among the three groups regarding satisfaction with life, disability, social phobia, anxiety, depression, and frailty (p≤0.05). In the multinomial regression analysis, being "not happy" was significantly associated with satisfaction with life (RRR: 0.53), depression (RRR: 1.46), social phobia (RRR: 1.24), and age (RRR: 1.06)., Conclusion: The present findings indicate that psychological factors and age influence the levels of happiness in older adults living in the community. Furthermore, better screening, diagnosis, and treatment of mental health disorders could increase the feeling of happiness among older adults., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Introduction: Older caregivers living in rural areas may be exposed to three vulnerable conditions, i.e., those related to care, their own aging, and their residence context., Objective: To analyze the association of burden and frailty with cognition performance in older caregivers in rural communities., Method: In this cross-sectional survey, 85 older caregivers who cared for dependent elders were included in this study. Global cognition (Addenbrooke's Cognitive Examination - Revised; Mini Mental State Examination), burden (Zarit Burden Interview) and frailty (Fried's frailty phenotype) were assessed. All ethical principles were observed., Results: Older caregivers were mostly women (76.7%); mean age was 69 years. Cognitive impairment was present in 15.3%, severe burden in 8.2%, frailty in 9.4%, and pre-frailty in 52.9% of the older caregivers. More severely burdened or frail caregivers had worse cognitive performance than those who were not, respectively (ANOVA test). Caregivers presenting a high burden level and some frailty degree (pre-frail or frail) simultaneously were more likely to have a reduced global cognition performance., Conclusion: A significant number of older caregivers had low cognitive performance. Actions and resources to decrease burden and physical frailty may provide better cognition and well-being, leading to an improved quality of life and quality of the care provided by the caregivers.

Objective:: Assess the effect of a Health Education (HE) program on cognition, mood and functional capacity of participants in a University of The Third Age (U3A)., Method:: Controlled clinical trial. The HE Program consisted of 10 sessions with group dynamics, including orientations on disease prevention and cognitive stimulation exercises, lasting four months. Intervention Group (IG) n=13; and Control Group (CG) n=15. All were assessed at the start and end of the study, using Addenbrook´s Cognitive Examination-Revised (ACE-R), Beck Depression and Anxiety Inventory (BDI/BAI) and Functional Independence Measure (FIM)., Results:: Significant improvements were observed for the IG when comparing the total ACE-R score (p=0.001) and memory domain (p=0.011) before and after the intervention. For the CG, improvement was found in the memory domain only (p=0.027)., Conclusion:: a HE intervention program benefits the improvement in cognitive performance, particularly the memory of adults and active elderly who participated in a U3A.

Objective: to evaluate the relation between stress and optimism of elderlies who are informal caregivers for elderlies and live with children., Method: cross-sectional study on 50 elderlies who provide care to elderlies, live with children, and are registered in the primary health care. The interviews occurred in the participant's residence and we evaluated characteristics of the care-dependent elderly and of the children, sociodemographic characteristics, stress through the Perceived Stress Scale and optimism through the Pinto and Pais-Ribeiro Spirituality Scale, in the elderly caregiver. For statistical analysis we used the Spearman correlation test., Results: the mean level of stress was 23.9 points and of optimism was 3.3 points. Correlation analysis showed that the higher the level of optimism the significantly lower the level of perceived stress of elderlies who provided care to elderlies and lived with children., Conclusion: inversely proportional correlation was identified between stress and optimism.

Objective: To determine whether there are differences in the intensity of chronic pain of elderly caregivers who are frail, pre-frail and non-frail., Methods: Quantitative, descriptive and cross-sectional study. The subjects were 187 elderly caregivers evaluated with a Multidimensional Pain Assessment Scale and the Fried Frailty Phenotype Assessment Components. Descriptive and comparative analyzes, Pearson's chi-square test and Kruskal-Wallis test were used., Results: 24.1% of the caregivers were frail, 55.1% pre-frail and 20.9% non-frail. The only socio-demographic variable that differed between the three groups was age (p=0.03). Mean pain intensity values were as follows: frail elderly (6.98), pre-frail (6.38) and non-frail (5.85). However, these differences were not significant (p=0.150)., Conclusions: The present study did not find a significant difference in the intensity of chronic pain in elderly. Nevertheless, it is essential that health professionals and health care public policies give special attention to older caregivers.

OBJECTIVE Comparing the differences in the sociodemographic, care and health profiles of elderly caregivers of the elderly living in urban, rural, and high social vulnerability contexts. METHOD A cross-sectional study developed with elderly caregivers enrolled in the Family Health Units of a municipality in the interior of São Paulo. Household interviews and evaluations were conducted on: Activities of Daily Living (ADL), self-reported pain, frailty, cognition, life satisfaction, family functionality, burden, stress and hope. RESULTS A total of 343 elderly caregivers of elderly individuals participated in the study, of which 55.1% lived in an urban context, 23.6% in rural areas, and 21.3% in a context of high social vulnerability. The majority of elderly caregivers were women across the three contexts, with a median age of 67 years and caring for their spouse. Caregivers from regions of high social vulnerability had lower education level, received less emotional and material help to care, were less satisfied with life, more fragile, in more cognitive decline, had worse family functionality and a lower level of hope when compared to caregivers of urban and rural contexts (p≤0.05). However, caregivers from areas of high vulnerability were more independent for ADL. CONCLUSION Professionals working in Primary Care should consider these differences when planning interventions aimed at the specific group of caregivers.

Background: The number of elderly caregivers is increasing in the world. It is important to know the attitudes toward the elderly, because they can influence a range of behaviors. Our aim was to determine factors associated with attitudes toward the elderly in a sample of older carers., Methods: Three hundred and thirteen elderly caregivers (75.4% women, mean age 69.7 ± 7.1) who cared for a dependent older person at home completed a cross-sectional household interview. In addition to the four domains of the Neri Scale to Assess Attitudes Toward the Elderly, participants were evaluated regarding the demographics, care recipient (CR) characteristics, functional and cognitive status, general health, life satisfaction, perceived stress, and depressive symptoms., Results: Overall, attitudes toward the elderly were neutral in this sample. More negative attitudes in some Neri Scale domains were associated with being older, living in an urban setting, taking more medications per day, caring for an elderly dependent in basic Activities of Daily Living (ADLs), being "more or less" satisfied with life, and having higher levels of perceived stress. There was a negative association between positive attitudes and educational level., Conclusions: The results highlight the need for public policies to promote more positive attitudes toward aging and change negative stereotypes usually used to designate older people. These public policies can try to modify some predictors of negative attitudes, such as perceived stress, which was associated with all four domains of Neri Scale.

Objective: Factors associated with perceived stress in older people have been studied previously, but this investigation in elderly caregivers is still scarce in the literature. Our aim was to assess factors that are associated with perceived stress in a sample of elderly caregivers., Methods: This cross-sectional investigation assessed 341 elderly caregivers who cared for a dependent older person at home. They answered questionnaires including the Perceived Stress Scale (PSS-14), a sociodemographic and care characterization, health and cognitive status, and burden related to care., Results: The mean score in PSS-14 was 18.5±9.9. Self-reported pain, difficult to sleep, "very poor/poor" self-rated health, impaired cognitive status, more people living in the house and higher levels of burden related to care were associated with higher levels of perceived stress., Discussion: The results highlight the importance of the development of stress-reduced interventions directed to elderly caregivers focusing on the associated variables in this study. Attention should be given to cognitive decline prevention and strategies to avoid or reduce burden in the elderly caregivers., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

The objective was to identify the sociodemographic profile of the elderly victims of trauma, to characterize preexisting conditions and medications taken at home, and to calculate indices of trauma and clinical outcomes. This is a retrospective and exploratory analysis from a database of a general hospital between 2008 and 2010. There were studied 131 elderly, mean age 69.9 years, 73.3% male, 55.1% married, 54.7% retired, 65.6% had preexisting conditions and 48.9% used drugs at home. There was a representative number of falls (31.3%), followed by running over (28.2%), with the head/neck region being the most affected (59.5%). Moderate trauma prevailed (44.3%), with conditions of survival after the event (80.2%). There was an association between mechanism of trauma and preexisting disease (p=0.01) and between mechanism of trauma and sex (p=0.03). The knowledge of the variables involved with the elderly victims of trauma enables healthcare professionals to plan preventive measures aimed at improving the assistance.